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MDC 1 Final Exam ReviewManaging open fractures, how to prevent infectionFrequent dressing changes with aseptic technique, monitor temperature and heart rate, administer broad spectrum antibiotics as ordered (Clindamycin and Gentamycin), irrigate open wound (clean to dirty)Managing ambulation with client who has cancer➤Ask the patient to wear nonskid footwear.➤Place the bed in low position and lock the wheels.➤Assist the patient to dangle at the side of the bed ➤If two nurses are available, each nurse should stand facing the patient on opposite sides of the patient.➤Brace your feet and knees against the patient. Bend your hips at the knees and hold onto the transfer belt. Pay attention to any known weakness.➤Instruct the patient to place her arms around you between your shoulders and waist (the location depends on the height of the patient and the nurses).Ask the patient to stand as you move to an upright position by straightening your legs and hips.➤Allow the patient to steady herself for a moment.➤One nurse: Stand at the patient’s side, placing both hands on the transfer belt. If the patient has weakness on one side, position yourself on the weaker sideSlowly guide the patient forward. Observe for signs of fatigue or dizziness.➤If the patient must transport an IV pole, allow the patient to hold onto the pole on the side where you are standing. Assist the patient to advance the pole as you ambulateOA/RAOA: Degenerative condition. Wear and tear. Loss/wear down of articular cartilage in the joint which causes pain, stiffness, and crepitus (cracking/popping sound). Aggravates with weight-bearing joint use (weight loss, physical exercise, ice) RA: Chronic, inflammatory, autoimmune disorder that causes bone erosion, joint deformity, and painful swelling. Aggravates with weight-bearing joint use. Inflammation and pain with no activity. Ice and heat. Adequate rest. NSAID’s. Stretching. Knee pain assessmentClient history, knee inspection for joint effusion/swelling/warmth/deformity, palpate for point tenderness, AROM/PROM, neurovascular assessmentDischarge instructions for osteomyelitisImportance of medication adherence and taking full-course, signs/symptoms/re-infection detection, importance of hand hygiene, proper irrigation techniques, assistive device use, assistance with ADL’s
Total knee repair managementDVT/PE prevention/monitoring (TED hoses, anti-embolic/anti-thrombotic stockings) , surgical dressing changes and monitoring of incision site for infection, observation of mobility and sensation, ABC’s, no excessive blood/fluid loss, monitor tissue perfusion 90 degree ROM- elbowAssessment for patient on bedrest w/pain in legPROM, neurovascular assessment for DVT/PE, pain assessmentImportance of ROMImproves joint function, balance and muscle strength, flexibility, reduces pain and stiffness, improves circulation, reduces injury potentialAbduction/adductionAbduction pillow or 1-2 pillows placed between the legs to remind the client to keep their legs abducted.